Healthcare Provider Details

I. General information

NPI: 1124621461
Provider Name (Legal Business Name): CINDY LYNN KAPILOFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 11/19/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

452 ROUTE 9
WARETOWN NJ
08758-1710
US

IV. Provider business mailing address

900 BARNEGAT BLVD N UNIT 602
BARNEGAT NJ
08005-2536
US

V. Phone/Fax

Practice location:
  • Phone: 609-693-6030
  • Fax:
Mailing address:
  • Phone: 609-489-4391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02614400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: